T Nation

Strange Stuff from the Endo, Comments

I have posted this on another forum, and had some interesting comments. All in all you people seem to have a better handle on this type of thing. So I would like to see what you have to say.

K here it goes. I have been showing signs and symptoms of low T for several years (53 yo). My gut keeps getting bigger even when consuming 2000 calories per day and working out hard 4X per week, low libido, not ED just takes more to get me interested, always tired due to poor sleep patterns, and so on. The family doc ran the standard blood tests and pretty much said, “Yep everything is good”. Well after a time of complaining he sends me to a endo for a consultation. More blood work for the endo. Three times over three months before he would even see me. I never seen the orders, so I have no idea what he was looking at. His office just told where and when to show up and I did.

The upshot is the endo looks at me and says “You have depression”. No I am not. I’m one of the happiest guys I know. Good job, solid marriage to a dedicated good looking gal, no drama on any front. I do not get panic attacks, fear or any of the other stuff associated with depression. He says “No, you have sub-sydromal, non-clinical depression.” WTF??

He then goes on to explain that my serotonin levels are messed up. (I thought the only way to accurately check that was in urine, but what do I know). And I am not using the insulin my body is making properly which explains the weight gain. DUH! (had to do that)

Since this is only to be a consultation he will be forwarding information and prescription ideas to my normal doc. He told me to eat in the lower side of the glycemic index, take fish oils and ALA. Which is supposed to help with the insulin resistence issue. (Uhmm…I take Flameout religiously already)

Well all this has me confused (which is easy to do). My google searches on serotonin and sub-clinical depression really left me scratching my head because of the contradictory and some absolutly non-sense articles.

Can you add something that may clear this whole sub-clinical depression thing up for me? I will be seeing the family doctor tomorrow, but my curiosity has gotten the better of me.

An endocrinlolgist has NO business diagnosing depression from lab values. Depression should be formally diagnosed by a psychiatrist, who has the education and training to do so.

Tell your endocrinologist to go pound sand, and find a progressive doctor that listens to you, not a quack that can’t diagnose his way out of a paper bag, because he can’t think outside the box of labwork.

Insist that your doctor give you a copy of all blood results.

When I say that you should “insist” on copies of the blood work, what I mean is that both of these doctors are treating you like a child and so far you’re letting them do that to you. They will continue to treat you like a child until you force them to treat you like a man.

The bottom line is that you can’t know what’s going on until you can see the blood work yourself.

“Yep everything is good” is a bullshit statement. If you’re not prepared to call bullshit on your doctor, then he will continue to blow smoke up your ass and your health will continue to deteriorate.

I’m on your side all the way as I have been in your shoes. But now is the time for you to take charge of your own health and stop letting these assholes treat you like a child.

What are the fasting serum glucose numbers? This might help eval the possible insulin-resistance, syndrome-X, metabolic disorder possibilities.

Yes, get and retain ALL copies of original lab results. Transcripts should be avoided. You need numbers and lab ranges. We need those numbers.

You can order your low labs from LEF.org and we can help you understand your numbers, what you have, what you need and treatment options. Then you can look for a doctor and make your case.

Well, got back from the family doc today. He pretty much said he doesn’t agree with what the endo stated. That the endo did not supply anyblood work numbers to back up his depression statement.

The endo did not even mention anything about me having low seritonon levels in his report to my doc. Damn me, I should have asked for a copy of the endo’s letter. (Call me paranoid, but I would be interested in know if the endo said I was nuts or fishing for HRT).

My doc did say he has rethought my situation and believes that I am insulin resistant and possibly metabolic syndrome. He wants me to load up on the Omega 3’s and do the low glycemic diet.

FWIW, here are the results from my last bloodwork a few months ago.

My triglycerides are high (165 on a scale of 100-155mg/dl), my LDL cholesterol profile is OK 90 (0-130mg/dl), LDL is a bit low 27 (30-60 md/dl), serum glucose is 95 (65-100 mg/dl) BUN is a tad high at 25 (8-24 mg/dl), but has been pretty much isolated to my high protein diet and I need more water intake.

Testosterone 331 (241-824 ng/dl)
GH 0.1 (0-6.0 ng/ml)
TSH 1.08 (0.350 - 5.50 uIM/ML)
T4 6.4 (4.5 - 12.0 ug/dL)
T3 uptake 36% (1.2-4.9)
Free Thyroxine 2.3 (1.2-4.9)

Someone asked about my sleep. I have had a sleep sudy done a year ago. The results were I was restless, waking often, but no apnea.

As always, more comments are welcome and thanks for the input.

My opinion would be TRT even if it’s just as an anti-aging option and not to fix an actual problem. Even if it doesn’t fix your libido or other symptoms it will transform your body and you’ll feel great.

Honestly your endo may be right. I had similar T numbers to your’s and my endo also told me it was depression. After a year of tweaking TRT I found out for myself he was right. I’m now having some luck clearing up the depression on my own and it’s rather complicated. The problem with depression is the term is a horrible one for the condition. Depression doesn’t mean you have to feel sad or bad about yourself. Depression is an actual physical condition and depending on which neurotransmitter or combination of are screwed up you can have different symptoms. I’m just like you. I have a great life and I’m not sad or sitting around feeling sorry for myself. My problem is that I’m unable to feel pleasure or enjoy anything. My depression is more dopamine related. My sexual function follows my libido. If one is good so is the other.

That said DO NOT LET A FAMILY DR TREAT YOU FOR DEPRESSION. They’ll hand you a SSRI and chemically neuter you. It is quite easy to avoid the sexual side effects of antidepressants if you understand why SSRIs cause sexual dysfunction and how to blend meds to avoid it. PM me if you end up going that route and I can save you a lot of aggravation.

Thank you very much brentf13. BUt I have absutly no intention or need for SSRI’s. Now that you guys have chimed in and some others on another forum, it is starting to look like the Endo fucked this one up. I

am probably being too nice, but I will give this guy one more chance to explian just what it was he was saying and how he got to his conclusions. And then take it from there.

I will address the insulin resistence first. The family doc just wants me to eat low Glycemic Index and I found this modification of a Charles Poliquin protocol a while ago here on T-Nation:

Betaine HCl 300 MG N/A
Bitter Melon Ext. 200 MG N/A
Acacia Powder 400 MG N/A
Chromium 40 MCG 33%
Fenugreek Seed 1000 MG N/A
Na R-Alpha Lipoic Acid 150 MG N/A
Gymnema Sylvestre 100 MG N/A
Vanadyl sulfate 50mg

I ordered a batch from Custom Capsule. I will have my blood work done in a couple of months after starting this and see where it is. Gotta start somewhere.